SKIMS data recorded over 50,000 cancer cases between 2014 and 2024. Nun chai, smoked meat, pesticide-bombarded vegetables, chronic stress, woodwork—all possible carcinogens. Rising cancer cases do not represent a single Kashmir crisis but multiple small crises. Each mohalla, each village, may have its own risk environment.
Hibban Showkat
Within a single mohalla, two young women and a middle-aged man lost their lives to cancer. The other commonalities were the same locality and that all three died of brain cancer. Years later, another woman within a few metres of these houses was diagnosed with cancer.
There is, in fact, plenty of science that can explain such patterns. Epidemiologists refer to this as a cancer cluster, which means a greater-than-expected number of cancer cases occurring within a defined geographic area over a period of time. However, according to the National Cancer Institute, many suspected cancer clusters occur by chance, and in most investigations, no definitive cause is identified.
We can also seek to explain these patterns through environmental exposure and local risk environment frameworks. A mohalla shares a water source, air quality, food habits, and agricultural exposure. So a bad spring, pesticide-laden orchards, smoke, or soil pollutants may affect residents in ways that broader regional studies cannot detect.
Yet, in many such instances, we rarely see any inquiry follow. Deaths are mourned, then discussed briefly, and then eventually absorbed into everyday life. The first death was a shock; the second and third heightened the unease. The fourth diagnosis was even more shocking. Yet, paradoxically, the concern for shared risk factors—like the spring, the food, and the soil—diminished dramatically. This is the normalisation of cancer.
In Kashmir, with a plethora of such mohallas, cancer has become something people expect to hear about. People have begun to say, “Cancer has increased,” and thus, all the “increase” they see around themselves should be normal. With every new case, cancer carries less urgency and more resignation in the valley. This normalisation is perhaps also aided by a number of research papers, popular science headlines, and everyday doctor interviews, which all suggest the “increase.”
Kashmir has undeniably witnessed a noticeable rise in cancer cases over the past decade. Data from the Sher-i-Kashmir Institute of Medical Sciences (SKIMS) suggests that over 50,000 cancer cases were recorded between 2014 and 2024, with more than 5,200 new cases registered in 2024 alone.
As cases keep rising, researchers attempt to identify possible causes. Kashmir’s dietary practices have taken centre stage. Foods such as our beloved nun chai (salt tea), smoked tujje (meat), and pesticide-bombarded vegetables have been studied for the presence of carcinogenic compounds. The valley’s orchard-based economy—which apparently has no option other than relying heavily on pesticides—has long been studied as a source of carcinogens. Decades of political uncertainty and social disruption have also created chronic stress conditions. Medical research increasingly recognises that long-term stress may influence immune function, inflammation, and overall disease susceptibility.
There are so many explanations. Our aanchar (pickle) is probably also a carcinogen. The woodwork that Kashmir loves so dearly is also possibly carcinogenic.
One may then ask: what do we need to stop doing to save ourselves? But here emerges a deeper conceptual question: what if there is no single explanation? What if I need to stop doing one thing and you another? What if, in my village, pesticide exposure is the key factor? In yours, water contamination plays a role? In someone else’s dietary practices contribute? Elsewhere, stress, pollution, or entirely different exposures may be at work?
This is the causation unification problem—something that keeps happening in Kashmir. The tendency to search for one overarching explanation for rising cancer cases across the region fails to note that villages differ in agriculture, water sources, and lifestyle patterns. It is therefore plausible to say that cancer risks are locally influenced rather than regionally uniform.
If we consider the case, then rising cancer cases do not represent a single Kashmir crisis but multiple small crises. Each mohalla, each village, may have its own risk environment, under the direct control of its geography, economy, and social conditions. This becomes very concerning when we consider that despite so much research, local-level inquiry is absent.
This is where a novel approach may be necessary. Instead of studying cancer only at regional or district levels, researchers and policymakers may need to adopt micro-level epidemiology. People may not normalise cancer when the very close environment that surrounds them is investigated at a level that speaks against this normalisation.
If the third death or the fourth diagnosis had brought a team of experts to test the water in the mohalla spring, or the mohalla soil, the psychology of the people, if nothing else, would have changed. It can also be said that such an approach would improve understanding besides enabling targeted interventions.
While some clusters may indeed be coincidental—and the NCI’s caveat may matter—that does not mean investigation is pointless. We must note how heavily epigenetics affects cancer expression. The small-scale level of epigenetics may hold important clues.
Whatever we do, we cannot allow cancer to become normalised. Three brain cancers within a small mohalla should shake us. I am not sure if we have the resources to do so, but as cancer cases continue to rise in Kashmir, the most urgent question should not be only why cancer is increasing, but also whether we have begun to accept its presence too easily.
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